Multiparametric quantitative analysis of tumor perfusion and diffusion with 3T MRI: Differentiation between benign and malignant soft tissue tumors

Objective: To evaluate multiparametric MRI for differentiating benign and malignant soft tissue tumors. Methods: This retrospective study included 67 patients (mean age, 55 years; 18-82 years) with 35 benign and 32 malignant soft tissue tumors. Intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI)-derived parameters (D, D*, f), apparent diffusion coefficient (ADC), and dynamic contrast-enhanced (DCE)-MRI parameters (K^trans, K_ep, V_e, iAUC) were calculated. Myxoid and non-myxoid soft tissue tumors were divided for subgroup analysis. The parameters were compared between benign and malignant tumors. Results: ADC and D were significantly lower in malignant than benign soft tissue tumors (1170 ± 488 vs 1472 ± 349µm²/s; 1132 ± 500 vs 1415 ± 374µm²/s; p < 0.05). K^trans, K_ep, V_e, and iAUC were significantly different between malignant and benign soft tissue tumors (0.209 ± 0.160 vs 0.092 ± 0.067min⁻¹; 0.737 ± 0.488 vs 0.311 ± 0.230min⁻¹; 0.32 ± 0.17 vs 0.44 ± 0.28; 0.23 ± 0.14 vs 0.12 ± 0.09, p < 0.05, respectively). ADC (0.752), D (0.742), and K_ep (0.817) had high AUCs. Subgroup analysis showed that only K^trans, and iAUC were significantly different in myxoid tumors, while, ADC, D, K^trans, K_ep, and iAUC were significantly different in non-myxoid tumor for differentiating benign and malignant tumors. D, K_ep, and iAUC were the most significant parameters predicting malignant soft tissue tumors. Conclusion: Multiparametric MRI can be useful to differentiate benign and malignant soft tissue tumors using IVIM-DWI and DCE-MRI.